title: Comparison of the effects of carvedilol and nebivolol on diastolic functions of the left ventricle in patients with non-ischemic heart failure.
abstract: BACKGROUND
  We investigated whether carvediolol or nebiovolol with vasodilator properties will produce different effects on diastolic function of the left ventricle (LV) in heart failure (HF) with low ejection fraction (EF).
  
  
  METHODS
  Sixty-one non-ischemic HF patients with EF ≤40% randomly received carvedilol (n = 31, 16 male) or nebivolol (n = 30, 19 male). Clinical and echocardiographic evaluations were performed at baseline, 3 and 6 months after therapy. Mitral inflow velocities (E and A waves), deceleration time of E wave (DT), isovolumetric relaxation time (IVRT), mitral annular velocities (Ea and Aa waves) were evaluated. Mitral E/A and E/Ea ratios were calculated.
  
  
  RESULTS
  In carvediolol and nebivolol groups, mitral E/A ratio (from 1.08 ± 0.31 to 0.87 ± 0.30 vs. from 0.98 ± 0.20 to 0.80 ± 0.20, p = 0.30) and IVRT (from 108 ± 13 to 94 ± 10 ms vs. from 107 ± 22 to 92 ± 10 ms, p = 0.25) similarly decreased while DT prolonged (from 184 ± 40 to 218 ± 42 ms vs. from 193 ± 37 to 222 ± 36 ms, p = 0.71). Also, E/Ea ratio significantly decreased in each group (p = 0.01), but it was lower in nebivolol group than carvedilol group at 6 months (10.2 ± 2 vs. 11.8 ± 2, p = 0.01). Carvediolol and nebivolol reduced similarly N-terminal pro-B type natriuretic peptide level (from 666 to 137 vs. 661 to 123 pg/dL, p = 0.41, respectively) and improved functional capacity (p > 0.05).
  
  
  CONCLUSIONS
  At 6 month follow-up, carvedilol and nebivolol appear to similarly improve LV diastolic functions in non-ischemic HF patients.
authors.affiliation: Department of Cardiology, Medical Faculty, Suleyman Demirel University, Isparta, Turkey. adogan35@hotmail.com.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Dogan
authors.forename: Mustafa
authors.initials: M
authors.lastname: Karabacak
authors.forename: Senol
authors.initials: S
authors.lastname: Tayyar
authors.forename: Dogan
authors.initials: D
authors.lastname: Erdogan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ozaydin
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000008:administration & dosage; D058665:Adrenergic beta-1 Receptor Agonists / Q000008:administration & dosage; D002227:Carbazoles / Q000008:administration & dosage*; D000077261:Carvedilol; D003971:Diastole; D004305:Dose-Response Relationship, Drug; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D000068577:Nebivolol / Q000008:administration & dosage*; D011412:Propanolamines / Q000008:administration & dosage*; D016037:Single-Blind Method; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D058665:Adrenergic beta-1 Receptor Agonists; D002227:Carbazoles; D011412:Propanolamines; D014665:Vasodilator Agents; D000068577:Nebivolol; D000077261:Carvedilol